Background: Cognitive dysfunction has been reported in acute psychiatric patients for a long time. The detection of cognitive deficits is crucial both for clinical treatment and for predicting the psychosocial functional level in the further course of the disease. The SCIP is a well-evaluated screening instrument for the examination of cognitive performance in psychiatric patients. We recently integrated the SCIP into our routine admission and discharge assessments on two inpatient wards, and we examined the cognitive profiles of patients with psychotic and affective disorders over the course of their admission.Methods: Shortly after admission, and prior to discharge, patients were routinely referred for examination with the SCIP. A total of 529 assessments were completed on admission, and 227 returned for SCIP at the time of discharge. After standardization of the test results against a normative sample, we examined the normalized test values in terms of percentages of pathological cognitive performance based on the total SCIP score, and each of the SCIP subscale scores. We conducted cluster analysis to identify cognitive subgroups within the clinical sample.Results: More than 70% of the SCIP results on admission were pathological. At discharge, improvements were observed, especially on tests with attention and speed components. Cluster analysis identified two groups. The cluster with chronic patients showed poorer results at admission, but greater improvement and reached the level of the others at discharge.Conclusions: The SCIP appears to have value in routine diagnostic assessments, and in the quantification of improvements in cognitive performance during an inpatient stay. The greatest benefit was observed in chronically ill patients with many previous stays.Trial registration: DRKS00019825(retrospectively registered on 03.12.2019).

The disease course of psychogenic nonepileptic seizures (PNES) over a prolonged period of time remains unclear. The aims of the study were: 1. to describe the course of illness with a median follow-up time of 4 years and a range of 2-15 years; and 2. to identify distinguishing features between participants regarding seizure cessation, functional level and health-related quality of life. Formerly, inpatients of an epileptic ward diagnosed with PNES between 2000 and 2013 were contacted via mail. They were asked by questionnaire about illness characteristics, i.e., age at onset, PNES status at onset and in the course, treatments, psychosocial situation, and quality of life status. Two-thirds of the N = 63 formerly inpatients were female, their age at onset was 26.7 years. Seizure frequency decreased significantly over time, 31.7% were currently seizure-free, but still only 37% were regularly employed. Only 48% had a satisfying health-related quality of life. The remitted participants had a shorter duration of illness and higher health-related quality of life. Participants with a good level of functioning were more likely to be male, took fewer medications, and had a higher health-related quality of life. Those participants with higher quality of life were more frequently employed and had fewer seizures. As participants continue to be severely limited in their functional level and quality of life over the period under review, enhanced treatment approaches that address experiential avoidance seem to be needed.

Introduction: Substance use disorders (SUDs) are common, and there is evidence of clinically significant benefit of cognitive behavioral therapy (CBT). The efficacy of CBT in SUDs has been confirmed, although relapse rates of 40%–60% have been reported. An enhancement of CBT-based therapy through an animal-assisted intervention (AAI) with sheep to normalize the occurrence of negative emotions and improve positive emotions as well as mindfulness and self-efficacy expectancy was investigated.Methods: A single-session AAI with sheep in a group setting was investigated against treatment as usual over time. N = 36 psychiatric inpatients with SUDs were examined by questionnaires before and 1 week after the intervention and additionally immediately after the intervention.Results: Positive emotions improved significantly in the AAI group 1 week after the intervention with a medium effect size, but not in the control group. Similarly, mindfulness and self-efficacy expectancy improved over time in the AAI group. When exploratory results were evaluated immediately after the intervention while still on the farm, the effects in favor of AAI were even larger.Conclusions: AAI can thus be considered effective in improving positive emotions, mindfulness, and self-efficacy expectancy. The impressive effect sizes immediately after the intervention encourage us to consider what can be done to maintain these even greater effect sizes over time.Clinical Trial Registration: https://drks.de/search/de/trial/DRKS00027539, identifier DRKS 00027539.

Zusammenfassung: Ziel der Studie Abhängigkeitserkrankungen werden unter anderem schematherapeutisch behandelt. Es stellt sich die Frage, ob tiergestützte Interventionen die Effekte verbessern können. Methodik Während einer stationären psychiatrischen Suchtbehandlung mit schematherapeutischem Schwerpunkt wurde eine tiergestützte Intervention mit Schafen durchgeführt. Eine Kasuistik wird vorgestellt. Ergebnisse Das individuelle Modusmodell der vorgestellten Patientin weist nach der Intervention deutliche Veränderungen hin zu einer Stärkung des gesunden Erwachsenenmodus und fröhlichen Kindmodus und einer Reduktion der dysfunktionalen Modi auf. Schlussfolgerung Die tiergestützte Intervention, eingebettet in einen schematherapeutischen Kontext, wurde bei dieser Patientin als gut umsetzbar sowie beeindruckend wirkungsvoll hinsichtlich einer Modifikation des Modusmodells erlebt.

Background: In an initial pilot study, we investigated an animal-assisted treatment (AAT) procedure with sheep as an adjunct to treatment as usual (TAU+AAT) in psychiatric inpatients with substance use disorder (SUD). Over time, this TAU+AAT intervention significantly reduced negative emotions and improved positive emotions, mindfulness, and self-efficacy expectancy compared to TAU. In the current study, we aimed to replicate these results and extend the investigation to another group of inpatients with difficulties in emotion regulation, namely borderline personality disorder (BPD). Methods: A single-session AAT procedure with sheep in a group setting as an adjunct to treatment as usual (TAU+AAT) was examined in an RCT compared to TAU. A total of 29 psychiatric inpatients with SUD and 31 with BPD were examined (PRE vs. POST) using questionnaires on variables that included positive and negative emotions, mindfulness, and self-efficacy expectations. Results: In the SUD sample, significant effects between PRE and POST, with large effect sizes in all four outcomes, emerged for the TAU+AAT group, in contrast to TAU. In the BPD sample, similar time (PRE vs. POST) and group (TAU+AAT vs. TAU) effects were achieved for all outcomes. Conclusions: Repeatedly, this TAU+AAT intervention, which involved a single session with sheep, improved in all outcomes. Sheep seem to be suitable for AAT with a focus on mindfulness.

Hintergrund Weltweit wird von einer Zunahme des Konsums von Kratom berichtet. In Deutschland nicht als illegal eingestuft sind Wirkprofil und Entzugssymptomatik ähnlich wie bei Opiaten. Material und Methoden Ein Patient stellte sich zur Behandlung seiner sozialen Phobie in einer niedergelassenen psychotherapeutischen Praxis vor. Ein problematischer Konsum von Kratom wurde offengelegt, die Behandlungsplanung entsprechend angepasst. Ergebnisse Die körperliche Entzugsbehandlung wurde in Kooperation von der psychiatrischen Institutsambulanz und der psychotherapeutischen Praxis gemeinsam durchgeführt. Abstinenzsicherung und Behandlung der sozialen Phobie sind nun anstehende Ziele in der psychotherapeutischen Praxis. Diskussion Der Konsum von Kratom ist verbreiteter als augenscheinlich angenommen. Eine Entgiftung kann ambulant durchgeführt werden. Schlussfolgerungen Der Fall unterstreicht die Bedeutung einer ausführlichen Suchtanamnese, vor allem aber der einzelfallbezogenen Kooperation der Niedergelassenen mit den psychiatrischen Kliniken. Background An increase in the use of kratom is reported worldwide. The substance is not classified as illegal in Germany. The psychoactive effects and withdrawal symptoms are opioid-like. Method A patient visited a psychotherapy practice for treatment of his social phobia. Problematic use of kratom was disclosed, and treatment planning was adjusted accordingly. Results The physical withdrawal treatment was carried out in cooperation of the psychiatric outpatient clinic and the psychotherapeutic practice. Securing abstinence and treatment of social phobia are now upcoming goals in the psychotherapeutic practice. Discussion The use of kratom is more widespread than apparently assumed. Detoxification can be performed on an outpatient basis. Conclusion The case underlines the importance of a detailed addiction anamnesis, but especially of the individual case-related cooperation therapists. Publication Date: 06 May 2022 (online) © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany